Eupatorium: Clinical correspondence and commentary

by Sasha Daucus and Paul Bergner

Medical Herbalism 01-31-96 7(4): 10-12

One of my favorite winter herbs is boneset (Eupatorium perfoliatum). I group it with echinacea and golden-seal, as one of the herbs with broad use in infectious ailments. I’ve had great luck using it on flus and on herpes I and II. I surmise that it might have anti-viral properties from its effectiveness with these two, but haven’t seen it listed as such. In fact, in my reading, it doesn’t seem to be that commonly used. I stumbled upon it first through personal use for a flu: it’s common along creeks and soggy fields here in the Ozarks and I wanted to use it as a diaphoretic. That flu went away in record time, and I continued to explore the use of boneset, and now wouldn’t be without it.

At our clinic (a nursing-based wellness practice), I use it as a first line of defense if I suspect a viral rather than a bacterial infection. I use ten drops of the tincture in hot water, every half hour for up to five doses to encourage sweating. For ongoing flu symptoms (or herpes) I use 10 drops 4 times daily. If taken during the prodromal stages of flu or herpes, very often neither condition will express. If used later in the course of a flu, many cases will clear up quickly. It should be taken no more than 5 days running, which is seldom necessary: I advise clients that if it’s working, they’ll fell better after the first day or two at most.


The most recent case was a thirty-eight year-old woman, a registered nurse, who came to the clinic after having been unable to work for nearly two weeks. The symptoms had begun with nausea and vomiting and extreme fatigue. At the point I saw her, she was past the acute stage but was still seriously fatigued and had a poor appetite. She had been prescribed antibiotics by an M.D., which she had taken for the full ten day course with no sign of improvement. I recommended 10 drops of boneset immediately, and then four times daily for five days. I expected she would feel significantly better after a few doses, and told her to call me the next day to check in. When she did, she was delighted. she said: “After the first dose, I felt `normal’ for the first time since I got this. I’d been feeling `unreal’ like I was isolated from the world behind some kind of wall. That’s gone and I feel like I’ve returned to myself again.”

What are other herbalists’ experience with boneset?

Sasha Daucus: Doniphan, Missouri


Here are what some rather famous herbalists from the distant and recent past say about it:

- “Extolled for its many properties and uses against intermittent fevers, arthritis, gout, and epilepsy by early American physicians and the Indians, E. perfoliatum was a virtual panacea and was always found in the well-regulated house-hold. It was widely used by confederate troops, who drank hot infusions of the plant as a febrifuge and as a substitute for quinine (Lewis and Lewis).” The authors include it in their chapter of famous herbal panaceas.

- “The leaves and flowers of this plant are among the truly valuable remedies of our native materia medica. They have long been employed in family practice, and deserve to be esteemed as one of the most useful medicines of the people and though their intense bitterness has caused them to fall largely into disuse, they merit much more attention than is now given them by the profession.” William Cook, MD, 1869.

- “[Boneset] has always been a popular remedy in the U.S., probably no plant in American domestic practice having more extensive and frequent use; it is also in use to some extent in regular medical practice, being official in the United States Pharmacopoeia [Ed: 1820-1900]. It is largely used by the Negroes of the southern U.S. as a remedy in all cases of fever, as well as for its tonic effects.”

- “Echinacea is used on combinations with other drugs in many proprietary preparations. Other preparations contain [boneset] in combination with or instead of echinacea....Both plants are said to have tonic properties, enhancing resistance to infection. These medicinal plants are used above all in the treatment of acute virus infections where antibiotics are ineffective — primarily, therefore, for influenzal conditions (Weiss).”

- The famous German plant researcher H. Wagner investigated the immune-stimulating properties of extracts of various plants containing polysaccharides. The increase in phagocytosis, one measure of the activity of white blood cells, was compared to controls. E. perfoliatum polysaccharides, in concentrations of .001 mg/ml increased phagocytosis by about the same amount as polysaccharides from either Echinacea purpurea or Echinacea angustifolia roots in concentrations of .01 mg/ml (Wagner et al.). The boneset polysaccharides were ten times as potent as those from echinacea.

- “Febrifuge, expectorant, diaphoretic, tonic [bitter], laxative. Both the polysaccharides and the sesquiterpine lactones are immunostimulatory” (Wren).

Boneset is one of the first North American herbs to be learned from the Natives, its use being taught to the Pilgrims as a flu remedy. It was exported to England by the end of the 1600s. In the nineteenth century, it was one of the few herbs used by all schools of medicine and herbalism — Eclectic, Thompsonian, Physiomedicalist, Homeopathic, and Allopathic. It was also recognized as a panacea for both chronic and acute illnesses by the Native, Anglo, and African-American cultures. It is a mystery of medical history that such a potent medicine could descend from domestic panacea to being left out of some modern herbals completely.

Don’t confuse the plant with Eupatorium purpureum, usually known as Queen-of-the-meadow, but sometimes called “purple boneset.” E. purpureum is primarily used as a diuretic. The use of both plants was taught to New England colonists by Native American herbalist Joe Pye, but his name stuck only to E. purpureum, which is sometimes called Joe Pye weed.

Boneset has had a dual role in the history of American herbalism, being equally valuable in acute and chronic conditions. It was used in cold infusion for chronic conditions, and hot infusion for acutes. I think this dual nature — use in hot and cold infusion — matches the “signature” of the plant, fever and chills, as well as its botanical appearance. The paired opposite lance-shaped leaves appear to be joined at the bottom with the stem perforating them, thus the name “perfoliatum.” Like the extremely versatile yarrow plant, boneset has both warming volatile and cooling bitter components. Most people think of it now as a febrifuge and flu remedy, but part of its historical panacea status was its use as a tonic in chronic disease. Herbalists who use it only for the hot indications miss half the picture.

Cold Infusion

Here are some tonic properties listed by various writers for the cold infusion:

- Irritable forms of dyspepsia [weak digestion] (Cook)

- Particularly suited to the indigestion of the elderly (Grieve)

- Good for the “cough of the aged,” with abundance of secretion, but lack of power to expectorate.

- Rheumatic pains of the muscles, bones or joints when they are of neuralgic origin rather than due to inflammation of the tissues (Felter and Lloyd).

-Relaxing to hepatobiliary apparatus, promoting secretion of bile by the liver and also expulsion from the gall bladder into the digestive tract (Cook)

- Mild laxative effect on the bowels [Ed: perhaps secondary to stimulation of bile, which is a natural laxative] (Cook)

- A decided influence on the lungs, its soothing and toning influence on the respiratory organs (whether given hot or cold) is “of the most valuable character and is generally too much overlooked.” (Cook) Allays irritable cough (Felter and Lloyd)

- Chronic headache of intermittent character (Felter and Lloyd)

- Action on the above organs and conditions is slow and mild (i.e. suitable for the deficient or exhausted patient — a “wise woman” herb rather than heroic medicine) (Cook)

- It is contraindicated in cold infusion for cold and sluggish conditions of the stomach and loose bowels.

It is evident from the above points that boneset is not simply a flu remedy. It is tonic to the digestion, the lungs, the liver, the bowels, and the overall energy. I think all these effects contribute to its actions in colds and flus — it’s much more than an anti-viral diaphoretic.

Hot infusion

As a hot infusion, boneset was traditionally used to induce sweating and/or vomiting. A standard hot infusion is an ounce of the herb in a quart of boiling water; cover and let cool a bit. This is not one to take by the cupful — the dose is 1-3 ounces, or less than half a teacup. Cook says to repeat the dose “until the desires objects are obtained,” which means sweat or vomit. Emetic therapy has almost passed completely out of Western herbalism and medicine, and boneset’s emetic properties may have helped to kill the plant’s reputation. Those properties are easy to avoid by sticking to low doses.

Echinacea seems to work best for colds and flu if taken when the first signs appear. Boneset works the same way, but unlike Echinacea, boneset seems to work very well to clear up a mid-stage flu. Boneset also helps complicated colds, flus, and other feverish conditions. I understand the dynamics of a cold of flu this way: A person first becomes run down, with their digestion not quite right, their liver possibly sluggish, and their adrenals and energy level not up to par. This would be called a “deficiency” condition in Chinese medicine. A person can exhibit some symptoms of a cold, such as chronic cough, fever, or loss of appetite from this condition alone. In this state, a person’s resistance to environmental fluctuations — cold, wind, heat, etc — is reduced. Maintaining the steady-state temperature and other parameters of the body is a lot of work, and when the system is run down, it is harder to accomplish. After exposure to cold, usually a cold wind — we do call them “colds” after all — the system becomes overwhelmed, and the cold penetrates past the normal temperature barriers in the body. The result is further derangement of the flow of energy in the system, especially a weakening of the immune system at the surface of the body and of the flow of energy in parts of the nervous system. This is the point where an actual viral infection — which requires the above “fertile ground” before it can infect — might begin. In a simple cold or mild flu, most of these symptoms stay near the surface of the body, such as a runny nose, fever, chills, and general fatigue. In a more complicated condition, if the cold has penetrated the system to a deeper level, and especially if the underlying deficiency state was more serious, deeper symptoms appear, such as muscle aches, headache, nausea, a longer infection, and chronic “periodicity” of feverish symptoms as the body repeatedly but inefficiently tries to cast off the cold condition. Boneset earned its fame as a remedy for “intermittent fever” because it is so effective in such conditions, as it was in the case Sasha Daucus presented above.

I think boneset should also be investigated in low doses in other viral illnesses that are characterized by chronic immune deficiency and periodicity of fever and chills. Note that Daucus has found it useful in her practice for herpes outbreaks, which do not fit its historical uses, but are hot conditions of a periodic nature.

A nineteenth century anecdote

In my own experience, one or two low doses of boneset can seem to “jumpstart” the system, and reverse a deep-seated flu or other chronic condition that other herbs, including echinacea, won’t touch. Daucus’ experience and example above show this. An anecdote from the 19th century physician Dr. Charles Millspaugh show its potency even in long-standing conditions that match the indications of the plant: “When a young man, living in the central part of New York State, he was attacked with intermittent fever, which lasted off and on for three years. Being of bilious temperament, he grew at length sallow, emaciated, and hardly able to get around. During this time he was treated with cinchona bark and all its derivatives, cholagogues, and every other substance then known to the regular practitioner without any improvement. Finally the attacks came on twice a day. By this point he was unable to walk, except by supporting himself on rail fences and buildings along the side of the road. As he sat one day, resting by the side of the road, an old lady of his acquaintance told him to go home and have some thoroughwort [boneset] `fixed.’ and it would certainly cure him. On reaching home he received a tablespoon full of boneset syrup, and immediately went to bed. He had hardly lain down when insensibility and stupor came on, passing into deep sleep. On awaking in the morning, he felt decidedly better, and from that moment improved rapidly without further medication, gaining flesh and strength daily. Soon he was completely and permanently cured (Wood).

A contemporary anecdote

Such testimonials may be suspect in early American medical literature, but my own case is similar, if not as long-standing a problem. After moving recently from Oregon to Colorado, the combination of the stress of the move, the climate change from wet to dry, and the weather extremes of the Colorado mountains, with wild swings from Spring-like to sub-zero weather, occasional 100 mph winds (!), and exposure to the new “bugs” of the bioregion left me with a six-week chronic viral bronchitis with periodic flu-like symptoms recurring every four or five days. After two weeks I gave up on my own herbal skills and consulted a master Chinese herbalist from Taiwan. The situation improved, but kept recurring just when it seemed that it was gone. After six weeks, it took a serious turn for the worse, and my fever went over 102 degrees F. Again acupuncture and Chinese herbs helped, but it started to recur three days later. At this point I took three twelve-drop doses of a concentrated 1:1 boneset tincture over a period of eight hours. I felt the digestive stimulant and cholagogue effects immediately, as if something had become “unplugged.” I also felt energy moving strongly in the channels in my arms, neck, chest, and even in my feet, and the stiffness going out of my muscles. That night I fell asleep two hours earlier than usual, slept twelve hours, and began to steadily improve, just like the man from the 1900s above.

Two other stories from the last century show its benefit in non-feverish chronic conditions. In a case or neurasthenia (nervous exhaustion) of long standing, complicated by emphysema, the patient, an extremely nervous woman, regurgitated whatever food she ate. There was no nausea, the food simply came back up. Fifteen drops of the fluid extract of boneset every two hours cured the condition on the second day. It recurred several months later for a short time, but was promptly cured by a few more doses of boneset. Another case involved an elderly man who appeared ready to die from chronic incurable hiccoughs. Fifteen drops on boneset in an infusion on cayenne, once an hour, produced a permanent cure (Ellingwood).

Boneset has practically fallen from use in modern herbalism, but not because it doesn’t “work.” There are no shortages of flu epidemics in North America these days, and indeed public health officials suggest that we may be overdue for the “big one” — one of the periodic serious flu epidemics that kill large numbers of people.

Old herbal texts say that in the early 1800s, boneset was found hanging to dry in “every household or barn.” I suggest that every herbalist at least have some ready on their shelf.


Cook, WH. The Physiomedical Dispensatory. Portland, Oregon: Eclectic Medical Publications, 1985 [reprinted from 1869 edition]

Ellingwood, F. American Materia Medica, Therapeutics, and Pharmacognosy. Portland, Oregon: Eclectic Medical Publications, 1983 [Reprinted from the 1898 Edition]

Greive, M. A Modern Herbal. New York: Dover Publications, 1971 [reprinted from 1931]

Lewis, WH, Elvin-Lewis MPF. Medical Botany: Plants Affecting Man’s Health. New York: John Wiley and Sons, 1977.

Wagner V, Proksch A, et al. Immunostimulating polysaccharides (heteroglycans) of higher plants: preliminary communication. Arzneim Forsch 1984;34:659-660

Weiss, RF. Herbal Medicine. Beaconsfield, England: Beaconsfield, 1988 [translated from the German Lehrbuch der Phytotherapie

Willard, Terry. The Wild Rose Sceintific Herbal. Calgary, Alberta, Canada: Wild Rose College, 1991

Wood, Matthew. Personal communication (Book draft of materia medica in preparation). August 1992.

Wren, RC. Potter’s New Clycopaedia of Botanical Drugs and Preparations. Saffron Walden, England: C.W. Daniel Company, 1989
Copyright 2001 Paul Bergner   

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